As an empiricist I long ago took against Freud, who was undoubtedly a profound thinker but one far more interested in the glamorous side of his investigations than in the dour, tough stuff that might have established the soundness or otherwise of his conclusions. Like Freud, the best scientists are capable of dazzlingly adventurous leaps of the imagination and grand theories: physics, after all has a Theory of Everything, which seems pretty ambitious. Unlike Freud, though, science is committed to put interesting ideas to the test. Only in that way will incorrect notions meet with the fate they deserve: rejection.

Since his death, some of Freud’s ideas, such as the “weak or absent father” theory of homosexuality, have been developed into testable hypotheses and found wanting. The great man’s many distinguished detractors have included Nabokov, who famously dismissed the founder of “the talking cure” as “the Viennese quack”. For a sustained, devastating exposure of Freud’s “well-documented conceptual errors, relentless apriorism, disregard for counterexamples, bullying investigative manner, shortcuts of reasoning, rhetorical dodges, and all-around chronic untruthfulness”, in the words of reviewer Francine Prose, we can turn to Unauthorized Freud: Doubters Confront a Legend, edited by Frederick Crews.

Despite such onslaughts, the tenets of psychoanalysis developed by Freud, as elaborated and refined by his disciples, still have their adherents. Dodgy concepts including the tripartite development of infantile sexuality (oral, anal and genital stages) and the Oedipus Complex, which at least had the virtue of acknowledging the vital significance of sexuality from birth onwards, have been quietly sidelined in favour of equally unproven but less controversial ideas: modern analysts tend to talk about developmental traumas in terms of object relations theory, which does not put sex at centre-stage. Just as important as the theory, too, has been the mind-set of those who have been attracted to following in the old charlatan’s wake. I called them disciples, and indeed they have been a church: sexually conservative, orthodox psychoanalysis has been heavily hetero-normative until recent times, just like the major authoritarian, patriarchal, monotheistic religions, seeing homosexuality as a perversion.

And insofar as they have deigned to mention the subject in print, which has been not as much as might be expected, psychoanalysts have excoriated paedophilia in extravagantly florid terms. A relatively recent example of this is On Paedophilia, by Cosimo Schinaia, which I am presently in the middle of. A fascinating picture is emerging, in which the therapists come across as certifiably paranoid, raging against the sadistic persecutions they are made to suffer by their intelligent and devastatingly scornful paedophilic patients! Translated from the original Italian, the book tells us about a working group of psychoanalytically oriented psychiatrists and psychologists in Italy, coordinated by the author, who pool their experiences of working with jailed paedophiles and others referred by the courts. In Italy, perhaps, such work is not left, as it largely is in the Anglophone countries, to the robust, no-nonsense, just-do-as-you’re-told, approach of cognitive behavioural therapy (CBT).

It is easy to satirise these shrinks. They seem to come straight out of a Woody Allen movie, railing against their patients and then – what joy of joys, what schadenfreude! – falling out among themselves in a melodramatic storm in a teacup, a mini-maelstrom of neurotic, self-imposed anguish and anger, torment and trauma!

Yes, it is easy to make fun, and perhaps I will do so again if I review the book properly once I have finished it: there is certainly plenty more to talk about. For the moment, though, I feel it is worth focusing on the surprisingly positive potential of psychoanalysis. For those who can bring themselves to believe in it, as with those who believe in a religion, there are benefits, and they work best for true and sincere believers.

You may be surprised to hear that I have just mentioned one of those benefits: the falling out. Well, not the quarrelling as such, but the fact that Schinaia candidly admitted it had happened. The great thing about this is the honesty: analysts aim to examine their own feelings as well as those of the people they analyse: the dynamics of the psychological relationship between the analyst and the analysand are laid bare. They probe not only “transference” – the theorised redirection of a patient’s feelings for a significant other person, such as their father, to the therapist – but also “countertransference”, which recognises the therapist’s feelings towards a patient, which will never be entirely detached and objective. It is an enquiry which acknowledges that the therapist has unconscious feelings and vulnerabilities, just like the patient; and this acknowledgement binds the two together in their shared humanity. This sure beats the divisive effect of CBT, which separates the therapist as a never-wrong authoritarian from his inferior and always error-prone “client”.

Psychoanalysis can only ever be as good as its individual practitioners, of course. The bullies and fools among them will achieve nothing. This still beats CBT, though, which is positively designed to be administered by bullies and fools. They may not all be stupid but they might as well be. This is because they are required to stick rigidly and mechanically to a manual-based programme and procedures.

The English edition of Schinaia’s book carries a foreword by Donald Campbell, a past president of the British Psychoanalytical Association. Despite his eminence, Campbell’s rabid contribution appears to put him firmly among the bullies and fools. I mention him here, though, because he was an analyst at the Portman Clinic, London, now part of the Tavistock and Portman NHS Foundation Trust. Both clinics, Portman and Tavistock, have a psychoanalytic orientation and have attracted many big names, ranging from John Bowlby, the esteemed pioneer of attachment theory, to Valerie Sinason, the lunatic proponent of Satanic abuse. So, in quality terms it’s the ultimate mixed bag! The Portman has long been into forensic work with paedophiles but the numbers are tiny: CBT dominates the game.

One of the leading Tavistock figures in the latter part of the last century was Charles Rycroft, author of A Critical Dictionary of Psychoanalysis (1968) and Psychoanalysis and Beyond (1985). His most significant role in life, though, (well to me at least!) was to give a less than enthusiastic review of my book Paedophilia the Radical Case, in the Times Literary Supplement. So far so bad, but he was at least a genuine radical, unafraid to challenge conservative colleagues, and even Bolshie in the most literal sense, having been a member of the Communist Party prior to disillusionment over Stalin. He was also a long-time colleague at the Tavistock of R.D. Laing, such a toweringly rebellious character he was known for his school of “anti-psychiatry”, promoting the view that psychiatric treatments are often more damaging than helpful.

It was a MAP, Ben Capel, author of Notes from Another Country, who alerted me a couple of years ago to the fact that radicalism is still an interesting feature of the Freudian tradition, if very much a minority one. Everyone can access it in published works and for the lucky few who encounter an inspired analyst it may even reach them through good therapy.

One such writer/analyst whose name crops up quite a bit in Notes from Another Country is Adam Phillips. A marvellous essay of his appeared recently in the London Review of Books, called “Against self-criticism”. It is an examination of our internal policeman: conscience. Excitingly, he invites us to revolt against its more unreasonable constraints. We know that in society not all laws are good ones, and so it is in our own heads. Conscience is an internalisation of the moral imperatives we grew up with: it is the morality imposed on us by (usually) our parents’ expectations. Allowing ourselves to be utterly bound by it is to make ourselves a slave to the morality of others when we should be thinking for ourselves.

Phillips approaches conscience as Freud did, through Hamlet. In The Interpretation of Dreams, Freud used Hamlet as a way of understanding what Phillips calls “the obscene severities of conscience”. Hamlet was illuminating for Freud because “it showed him how conscience worked, and how psychoanalytic interpretation worked, and how psychoanalysis could itself become part of the voice of conscience”. Note, here, this psychoanalyst’s implied criticism of conservative psychoanalysis.

The fateful character flaw of Hamlet, Prince of Denmark, the eponymous hero of Shakespeare’s most famous tragedy, is his indecision. Honour requires him to avenge the death (by suspected poisoning) of his father, the rightful king. The old king’s throne has been usurped by Hamlet’s uncle, Claudius, who has married Hamlet’s mother. But Hamlet hesitates. Conscience holds him back. Freud concludes that Hamlet has an Oedipal desire for his mother and the subsequent guilt prevents him from murdering Claudius, who has done what he unconsciously wanted to do. The loathing which should drive Hamlet on to revenge, Freud wrote, “is replaced in him by self-reproaches, by scruples of conscience, which remind him that he himself is literally no better than the sinner whom he is to punish.” Hamlet, in Freud’s view, turns the murderous aggression he feels towards Claudius against himself. Freud uses Hamlet to say that conscience is a form of character assassination, whereby we continually mutilate and deform our own character. As Phillips puts it, “We know almost nothing about ourselves because we judge ourselves before we have a chance to see ourselves.”

Adams says conscience is:

“…moralistic rather than moral. Like a malign parent it harms in the guise of protecting; it exploits in the guise of providing good guidance. In the name of health and safety it creates a life of terror and self-estrangement. There is a great difference between not doing something out of fear of punishment, and not doing something because one believes it is wrong. Guilt isn’t necessarily a good clue as to what one values; it is only a good clue about what (or whom) one fears. Not doing something because one will feel guilty if one does it is not necessarily a good reason not to do it. Morality born of intimidation is immoral. Psychoanalysis was Freud’s attempt to say something new about the police.”

The implication for MAPs brought up to regard sexuality as a furtive thing, a guilty pleasure to which children should not be exposed, is obvious. We (and this definitely includes me personally) all too commonly find conscience an unreasonable burden, an unwanted legacy from our parents. It’s the white elephant in the backroom of our minds: try to ignore it as we may, it never leaves us. What radical psychoanalysis may be able to do, though, is to challenge its validity by showing us precisely why we do not need to have a bad conscience over our refusal to be bullied by the dictates of conscience, provided we have a principled alternative – as many of us do.

Rycroft, C. “Sensuality from the start”, Times Literary Supplement, 21 November 1980

Schinaia, C. On Paedophilia, Karnac, 2010

MOST PEOPLE ARE IGNORANT

Ed Miliband was leader of the British Labour party until it suffered an unexpectedly heavy defeat in the general election last week, whereupon he fell on his sword. One criticism now being levelled at his leadership is that he was too intellectual, a theorist out of touch with the people. He unrealistically tried to convert the voters to his views rather than embrace theirs.

But what if Ed’s views were right and those of the voters were wrong? Everyone agrees he is a clever man, a deeper thinker than most of his opponents, so there is every chance his analysis was far superior to that of the average voter, whose understanding of economics, for instance, is woefully deficient. If they hear the name Keynes they probably think it’s a reference to the sticks teachers used to beat kids with.

Shouldn’t leadership, in a democracy, be about teaching the electorate rather than just pandering to their ignorance? On issues from climate change to child sexuality, it is vital that the public is somehow compelled to listen and learn occasionally. Otherwise we are doomed.

When New York psychoanalyst Dr Sue Kolod asked my advice over a patient who might be paedophilic, I was pleased but not entirely surprised – pleased because usually the very last person to be consulted on matters of minor-attraction is a minor-attracted person; unsurprised because Sue and I are both members of Prof. Mike Bailey’s forum, Sexnet, so she already knew quite a lot about me from reading my posts over a couple of years.

An email exchange followed, in which I did my best to give an honest, straightforward, opinion; after that I thought no more of it. Then, quite a long time later, out of the blue, comes news from Sue that she had drafted a book chapter featuring the patient in question and also our emails. She was going to be on a conference panel looking at the “scandalous” patient. Would I be prepared to answer some questions for her, as background preparation? After seeing her interesting chapter, I was happy to do so. We have talked quite a bit here at Heretic TOC about whether MAPs should have any dealings with the mental health world, and if so how. So this seemed a valuable opportunity to explore a model of engagement that might turn out to be more useful than the typically coercive kind encountered in forensic and penal settings.

Sue’s conference contribution, as I hoped, was very positive. The event as a whole, aimed at mental health professionals, was wide-ranging, with “the unspeakable” as a major theme. The full title of her panel’s joint session was “The ‘scandalous’ patient: outrage, titillation and compassion”. The quote marks around “scandalous” conveyed the idea, even before Sue spoke, that not every alleged scandal should necessarily be considered scandalous. So that was a good start.

Before coming to the specifics of Sue’s speech, I think it is important to put ourselves in the shrinks’ shoes. Strangely, in view of the great emphasis Freud put on sex, the training of the modern analyst – and the same is even truer of the cognitive behavioural therapy (CBT) types – does not typically extend to a sophisticated understanding of sexuality and its diversity. Apparently psychoanalysis is mostly about object relations theory these days. so there is plenty of scope, especially among analysts whose own sexuality is “normal”, to be all too easily susceptible to accepting supposedly “scandalous” behaviour at face value. Accordingly, the real struggle for understanding in which even the most humane and well intentioned therapist must engage is worth bearing in mind in what follows. The official programme notes introducing the panel capture quite well this tussle of the imagination:

Patients involved in a sex scandal or other “scandalous” activities can evoke reactions of disgust, fascination and sexual arousal in the analyst. They are often transformed from suffering patients into special exotic beings. This panel will discuss the disorientation that can ensue when scandal takes center stage and how the clinician can regain equilibrium.

I heard Sue’s talk from an audio recording she kindly sent me. She told her audience she had wanted someone alongside her on the speaker’s panel who had actually been involved in a scandal. She tried American politicians Eliot Spitzer and John Edwards but neither was keen once they knew the subject. So that was where I came in, as an “unapologetic paedophile” who had been “the head of a pro-paedophile organisation”. She said the conference committee rejected the idea of giving me a platform, as this might be seen as endorsing undesirable behaviour. She may not have realised this, but I would probably not have been allowed into the US anyway!

Sue said she had learned, in preparing for the conference, that even just by showing yourself ready to hear a person out, if they have been in a scandal, you get implicated in the scandal yourself. But scandal can be based on gossip. What people make of it can be very different from the original event. Thus anyone can be caught up in scandal. Also, it is relative: what would once have been scandalous no longer is, and vice versa. Not that long ago famous psychoanalyst Harry Stack Sullivan (1892-1949) was able to have sex with his patients without causing a scandal. This is because it was hushed up – something that could not happen today. But what is even more amazing is that James Inscoe, allegedly an underage male hustler, a patient of Sullivan’s or both, became his partner. That would be utterly beyond the pale now, but not then, when Sullivan encouraged his male gay patients to have sex with him.

On how people react to scandal, Sue quotes with approval an article “The Sex Monster”, by sociologist Abby Stein: “We have all have disowned parts of ourselves that wish to do harm. In the presence of perpetration, we may be repelled but we are also excited. In an odd way, people who have done awful, lurid, sexual things to others are not just more interesting to both lay and professional folk, they are downright sexy.”

Against this background, in which even professionals are not immune from feelings of both outrage and titillation, Sue recounted the story of her patient Frank, arrested and jailed after being accused of sexually abusing his seven-year-old granddaughter. Charges were dropped when the child recanted, but by then he had lost his job and the taint of scandal continued to poison his professional and family life. His file was kept open by the Administration for Children’s Services (ASC) and he was only permitted supervised visits with his granddaughter. He went voluntarily to therapy to be treated for depression and PTSD: he was having revenge fantasies over being got into trouble. He had also hoped Dr Kolod would provide a letter to say he did not fit the profile of a typical paedophile. Such a letter, his lawyer had told him, might persuade the authorities to close their file on him.

However, she began psychotherapy on the condition that Frank not ask her to advocate for him with ASC, with his family or in any court-related hearings. This was because there was no way she could know that the original allegations were false. My own opinion, having read some of the details of the case in Sue’s book chapter, is that the granddaughter’s original account could well have been true.

Frank was in therapy with Sue for two and a half years. His presenting problems abated without her ever being sure he was or was not a paedophile. She said the case gave her a problem of “countertransference” i.e. loosely speaking, emotional entanglement with her client. She had feelings of disgust, apprehension, outrage and fascination. In her book chapter she wrote:

Never sure whether I could trust my gut instincts, I was more distant with Frank than I usually am with my patients; more suspicious and also less likely to ask pertinent questions. For example, I was unusually reluctant to inquire into Frank’s sexual life and fantasies, a subject that was clearly relevant. I often experienced a distinct “not me” reaction to him. In short, I was uncomfortable with the idea of finding myself in him.

In an attempt to neutralise these feelings she decided to do something unorthodox. She would engage not with a fellow professional but with a paedophile: me! This would give the opportunity to see her feelings “in a context”. She took my advice not to seek a confession from Frank. After this, she said, her countertransference diminished: she was more able to see him as a suffering human being. She realised her job was to treat what he had come in for: depression and PTSD, not paedophilia. In the book she wrote:

Subsequent to this email exchange, I completely stopped trying to get Frank to confess to anything. Once I relinquished responsibility to get him to confess, I found that I was able to empathize with him. I stopped feeling either apprehension, disgust or fascination towards him and was able to experience him as a fellow suffering human being. My exchange with Tom O’Carroll helped me to “defetishize” my patient and to see him as “more simply human than otherwise”.

Sue read out from the emails between us. In the Q&A that followed her talk another analyst, Dr Mark Blechner, described it as a “remarkable exchange”. Sue wrote to me afterwards saying that Blechner, who is a training and supervising psychoanalyst at the William Alanson White Institute, which was holding the conference, “advocates if you have a patient with a problem or condition with which you are not familiar, it is important to consult with an expert on the subject. He was very laudatory of our interchange for that reason.” Blechner is the author of Sex Changes: Transformations in Society and Psychoanalysis (2009), a major theme of which is that some sexual practices once thought to be disgusting, perverse and illegal have become accepted.

After about two years, when Frank’s symptoms had significantly abated and he was doing a lot better, Sue finally felt able to confront her resistance to asking about his sexuality. She had sensed “an erotic transference”, with Frank becoming attracted to her. Frank told her he had become infatuated with a younger woman but was still married to his wife. In a dream he had been brought up against the need to decide. Sue recognised ambiguity in what he was saying: was the “younger woman” of his dreams his little granddaughter? This led her to have dreams herself, in which her countertransference came back, albeit in a milder form than before. She dreamt Frank was her date. When he embraced her, she was disgusted and broke free. Frank became despondent. She then felt guilty and sorry for him.

As treatment drew to a close Frank thanked her for all her work but also frequently asked if she believed him when he said he was not a paedophile. Her answers validated his understanding that some ambiguity remained in her mind, but despite that the pair parted “with warmth and loving feelings towards each other”.

Having heard all this in Sue’s talk, I found myself astonished and impressed by the candour with which she had described her own complex, deep and ambiguous reactions to her engagement with Frank. We MAPs, it seems to me, all too often fail to take account of the fact that even with the best will in the world, which I think Sue was demonstrating, it is extraordinarily difficult, when confronted with a demonised Other, just to toss that sense of Otherness out of one’s mind. So I believe we should respect that sincere effort, especially when it leads to a positive outcome, as in this case.

Sue recently wrote about follow-up work:

I am currently teaching a course at White on psychoanalytic process. I am playing recordings of my sessions with “Frank”. He gave me permission to tape him and to use the tapes for teaching purposes. At the last class I read from my correspondence with you and the students reacted very positively. They said that your comments helped them to see the patient in a more human light rather than as the “exotic other” – exactly the point of my presentation at the conference!

To be honest, my comments in those emails strike me as no big deal. It was very basic, simple stuff that focused in a matter-of-fact way on the patient’s feeling that the therapist should be there for them, not as some sort of detective trying to solve a crime. It is a simple message that accords well with traditional medical ethics. Encouragingly, it was taken seriously in this case.

Well, I say encouragingly, but it is a moot point whether MAPs will be able to secure ethical treatment in other settings. Those who find themselves coerced into taking part in sex offender treatment programmes at present are almost certain to find they are treated by therapists who regard crime prevention as their first goal, with the interests of the nominal “client” coming a vanishingly distant second. These are nearly all manual-based, one-size-fits-all CBT programmes in which the individual is systematically bullied into conformity. Treatments rooted in the Freudian tradition have at least taken an interest in looking deeply into people as individuals, but these probings, too, can be oppressive in a context of promoting “normal” sexuality: psychoanalysis since Freud, especially in America, has a poor track record of accepting even plain vanilla gayness as anything other than pathological.

As we have seen from Sue’s approach, though, the world of psychoanalysis is perhaps not as monolithically conformist as it perhaps once became in the US. It was a “sex offender”, actually, who first alerted me to its more radical possibilities. Ben Capel’s Notes from Another Country drew my attention to the fact that analysts such as Jacques Lacan, his protégé Jean Laplanche and British practitioner Adam Phillips (who gave the opening keynote speech at Sue’s conference) have struck a far less politically correct tone. Perhaps organisations such as B4U-ACT and its fledgling British equivalent FUMA (Forum for Understanding Minor Attraction), may see some merit in pointing individual MAPs in the direction of therapists who subscribe to this more radical tradition. This need not commit anyone to signing up for the sometimes abstruse theory these guys go in for: it’s the spirit that counts. Lacan himself is long gone; Laplanche died last year; Phillips, however, born in 1954, is still in private practice in London. As the William Alanson White Institute conference showed, there are also others.